Lifetime Personal Fitness

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Lifetime Personal Fitness

Test-Out Registration Form

Name: ________________________________ Student ID_______________

School: ___________________ Grade: _________ Date: _____________

Preparation and Practice are prerequisites for success in the Lifetime

Personal Fitness Test-Out.

To register for the Test-Out you must: 1) complete the tasks listed below, 2) choose a

date for testing, 3) obtain a parent’s signature, and 4) return this form to the Physical

Education Department Chairperson in your building at least one week prior to the date

you selected for testing. This completed form becomes your official registration.

The above named student has: Check each item as completed.

____ Picked up from the Counseling Office and studied and reviewed with parents, the

LPF Test-Out Packet

____ Attended at least 1 practice session offered by the Physical Education Department

at your school to review test-out protocols and practice for the mile run, curl up, push up,

and sit-and-reach flexibility test activities.

____ Viewed the 5 min. Test-Out CD or video available at your school through the

Physical Education and/or Counseling Departments.

____________________________________________________________________

District-wide Test-Out Dates: Select ONE

____September 21, 2006 THURS. 5:00 PM –7:00 PM Bartlett H.S. Wt Rm. Confirmed

____October 28, 2006 SAT. 9:00 AM – 11:00 AM Hanshew M.S. Lobby Confirmed

____ February 14, 2007 WEDS. 3:30 PM – 5:30 PM East H.S. Commons Confirmed

____ March 31, 2007 SAT. 9:00 AM – 11:00 AM Hanshew M.S. Lobby Confirmed

_____________________________________________________________________

Additionally, this student does ____ or does not ____ have a PERMANENT physical

limitation that may impact his/her ability to perform ONE of the test-out fitness activities.

Attach a physician’s note.

PARENT SIGNTURE: __________________________ Date ____________

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